NTA - National Tax Association
FAX / Mail Credit Card Form

Membership Registration

National Tax Association

725 15^th Street NW #600

Washington DC 20005-2109

Attn: Charmaine Wright FAX  to: 202 737-7308            

 

Card: Master: ___   VISA:___

 

 

Acct. No: ______________________________________  Exp. Date: ______Mo    ____Year

                 American Express, Not Available

Name On Card: _______________________________________________________

Amount: ___________________

 

Signature                                                                                           

 

 

Confirmation on request.